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https://www.readbyqxmd.com/read/28231239/surveillance-for-health-care-access-and-health-services-use-adults-aged-18-64-years-behavioral-risk-factor-surveillance-system-united-states-2014
#1
Catherine A Okoro, Guixiang Zhao, Jared B Fox, Paul I Eke, Kurt J Greenlund, Machell Town
PROBLEM/CONDITION: As a result of the 2010 Patient Protection and Affordable Care Act, millions of U.S. adults attained health insurance coverage. However, millions of adults remain uninsured or underinsured. Compared with adults without barriers to health care, adults who lack health insurance coverage, have coverage gaps, or skip or delay care because of limited personal finances might face increased risk for poor physical and mental health and premature mortality. PERIOD COVERED: 2014...
February 24, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28231042/cost-effectiveness-analysis-of-four-simulated-colorectal-cancer-screening-interventions-north-carolina
#2
Kristen Hassmiller Lich, David A Cornejo, Maria E Mayorga, Michael Pignone, Florence K L Tangka, Lisa C Richardson, Tzy-Mey Kuo, Anne-Marie Meyer, Ingrid J Hall, Judith Lee Smith, Todd A Durham, Steven A Chall, Trisha M Crutchfield, Stephanie B Wheeler
INTRODUCTION: Colorectal cancer (CRC) screening rates are suboptimal, particularly among the uninsured and the under-insured and among rural and African American populations. Little guidance is available for state-level decision makers to use to prioritize investment in evidence-based interventions to improve their population's health. The objective of this study was to demonstrate use of a simulation model that incorporates synthetic census data and claims-based statistical models to project screening behavior in North Carolina...
February 23, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28230452/prescription-drug-utilization-and-reimbursement-increased-following-state-medicaid-expansion-in-2014
#3
Nirosha Mahendraratnam, Stacie B Dusetzina, Joel F Farley
BACKGROUND: The Affordable Care Act (ACA) expanded health care and medication insurance coverage through Medicaid expansion in select states. Expansion has the potential to increase the availability of health services to patients, including prescription medications. However, limited studies have examined how expansion affected prescription drug utilization and reimbursement. OBJECTIVE: To compare prescription drug utilization (number of prescriptions filled) and reimbursement trends between states that did and did not expand Medicaid coverage in 2014, while accounting for known effects of expansion on Medicaid enrollment...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28228204/hospital-charge-and-health-care-quality-in-bariatric-surgery
#4
Dana A Telem, Jie Yang, Maria Altieri, Mark Talamini, Qiao Zhang, Aurora D Pryor
To determine if hospital charges correlate with patient outcomes after bariatric surgery. A retrospective review of 46,180 patients who underwent bariatric surgery from 2004-2010 was performed. Patients were identified using the New York Statewide Planning and Research Cooperative System database. Hospitals were categorized on estimates from a multiple linear regression model for charge: low (<$25,027.00), medium ($25,027.00-$35,449.00), and high (≥$35,449.01). Patient outcomes were compared among the charge classification...
February 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28221820/risks-benefits-and-importance-of-collecting-sexual-orientation-and-gender-identity-data-in-healthcare-settings-a-multi-method-analysis-of-patient-and-provider-perspectives
#5
Allysha C Maragh-Bass, Maya Torain, Rachel Adler, Eric Schneider, Anju Ranjit, Lisa M Kodadek, Ryan Shields, Danielle German, Claire Snyder, Susan Peterson, Jeremiah Schuur, Brandyn Lau, Adil H Haider
PURPOSE: Research suggests that LGBT populations experience barriers to healthcare. Organizations such as the Institute of Medicine recommend routine documentation of sexual orientation (SO) and gender identity (GI) in healthcare, to reduce LGBT disparities. We explore patient views regarding the importance of SO/GI collection, and patient and provider views on risks and benefits of routine SO/GI collection in various settings. METHODS: We surveyed LGBT/non-LGBT patients and providers on their views on SO/GI collection...
February 21, 2017: LGBT Health
https://www.readbyqxmd.com/read/28221275/changes-in-emergency-department-utilization-after-early-medicaid-expansion-in-california
#6
Lindsay M Sabik, Peter J Cunningham, Ali Bonakdar Tehrani
BACKGROUND: Medicaid expansions aim to improve access to primary care, which could reduce nonemergent (NE) use of the emergency department (ED). In contrast, Medicaid enrollees use the ED more than other groups, including the uninsured. Thus, the expected impact of Medicaid expansion on ED use is unclear. OBJECTIVES: To estimate changes in total and NE ED visits as a result of California's early Medicaid expansion under the Affordable Care Act. In addition to overall changes in the number of visits, changes by payer and safety net hospital status are examined...
February 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28220019/population-level-differences-in-rectal-cancer-survival-in-uninsured-patients-are-partially-explained-by-differences-in-treatment
#7
Dianne Pulte, Lina Jansen, Hermann Brenner
BACKGROUND: Rectal cancer (RC) is a common malignancy with a substantial mortality but good survival for patients with optimally treated nonmetastatic disease. Lack of insurance may compromise access to care and therefore compromise survival. Here, we examine RC survival by insurance type. METHODS: Data from the Surveillance, Epidemiology, and End Results database were used to determine 1- to 3-year survival for patients with RC by insurance type (Medicaid, uninsured, other insurance)...
February 20, 2017: Oncologist
https://www.readbyqxmd.com/read/28213893/disparity-in-dental-out-of-pocket-payments-among-older-adult-populations-a-comparative-analysis-across-selected-european-countries-and-the-usa
#8
Richard Manski, John Moeller, Haiyan Chen, Eeva Widström, Stefan Listl
BACKGROUND: The current study addresses the extent to which diversity exists in dental out-of-pocket (OOP) payments across population subgroups within and between the USA and selected European countries. This represents the final paper in a series in which the previous two papers addressed diversity in dental coverage and dental utilisation, respectively, using similar data and methods. METHOD: We used data from the 2006/2007 Health and Retirement Study (HRS) and from the 2004-2006 Survey of Health, Ageing and Retirement in Europe (SHARE) for respondents ≥51 years of age...
February 17, 2017: International Dental Journal
https://www.readbyqxmd.com/read/28213691/barriers-to-healthcare-among-african-immigrants-in-georgia-usa
#9
Oluwatoyosi A Adekeye, Bola F Adesuyi, Joseph G Takon
African-born immigrants are among the fastest growing immigrant groups in the US, yet they are underrepresented in healthcare research, particularly, cancer research and tend to be categorized as African American or Black, obscuring any cultural nuances that exist. A survey designed to provide insight on the barriers to healthcare, knowledge of common cancers, and cancer risks was utilized during a health fair. Data analyses included descriptive statistics to examine participant demographics and other study variables of interest...
February 18, 2017: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/28212899/outcome-disparities-by-insurance-type-for-patients-with-acute-myeloblastic-leukemia
#10
Dianne Pulte, Felipe A Castro, Hermann Brenner, Lina Jansen
Survival for patients with acute myeloblastic leukemia (AML) has increased during the past two decades. However, socioeconomic disparities may affect survival for some patient populations. We examine survival by insurance type for patients with AML. Using data from the Surveillance, Epidemiology, and End Results database we estimated survival according to insurance status (no insurance, Medicaid, and other insurance) for patients diagnosed with AML in the United States in 2007-2013. One, 3-, and 5-year survival was lower for patients with no insurance and Medicaid than for patients with other insurance...
February 3, 2017: Leukemia Research
https://www.readbyqxmd.com/read/28209637/the-impact-of-payer-source-on-trauma-outcomes-in-a-pediatric-population
#11
Felecia A Lee, Ashley M Hervey, Arash Sattarin, Aaron Deeds, Gina M Berg, Kimberly Molik
OBJECTIVES: Determine if there were differences in conclusions drawn regarding disparities in trauma outcomes based on literature-derived payer source definitions in a pediatric population. PATIENTS AND METHODS: Retrospective registry review of admitted pediatric trauma patients (≤17 years of age) at a level II pediatric trauma facility. Eligible patients were categorized into 3 payer source definitions: definition 1: commercially insured, Medicaid, uninsured; definition 2: insured, uninsured; definition 3: commercially insured, underinsured...
February 16, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28209594/adolescents-and-young-adults-with-acute-lymphoblastic-leukemia-and-acute-myeloid-leukemia-impact-of-care-at-specialized-cancer-centers-on-survival-outcome
#12
Julie Wolfson, Can-Lan Sun, Laura Wyatt, Wendy Stock, Smita Bhatia
Background: Adolescents and young adults (AYA; 15-39 years) with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) experience inferior survival when compared with children. Impact of care at NCI-designated Comprehensive Cancer Centers (CCC) or Children's Oncology Group sites (COG) on survival disparities remains unstudied.Methods: Using the Los Angeles cancer registry, we identified 1,870 ALL or AML patients between 1 and 39 years at diagnosis. Cox regression analyses assessed risk of mortality; younger age + CCC/COG served as the referent group...
February 16, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28199776/understanding-patient-perceptions-and-risk-for-hepatitis-c-screening
#13
Sheriedan Grannan
OBJECTIVES: The specific aims were to identify specific themes and barriers to HCV testing and to determine if testing rates increased when patients self-identify their risk factors and were offered testing. SETTING: The study was conducted at a Federally Qualified Health Center (FQHC) in an underserved neighborhood located in the Mountain West. METHODS: This descriptive study used survey and group-level electronic health record (EHR) data...
February 15, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28191371/the-effect-of-medical-student-volunteering-in-a-student-run-clinic-on-specialty-choice-for-residency
#14
Ashley Brown, Rahim Ismail, Glenn Gookin, Caridad Hernandez, Grace Logan, Magdalena Pasarica
INTRODUCTION:  Student-run free clinics (SRFCs) are a recent popular addition to medical school education, and a subset of studies has looked at the influence of SRFC volunteering on the medical student's career development. The majority of the research done in this area has focused on understanding if these SRFCs produce physicians who are more likely to practice medicine in underserved communities, caring for the uninsured. The remainder of the research has investigated if volunteering in an SRFC influences the specialty choice of medical school students...
January 9, 2017: Curēus
https://www.readbyqxmd.com/read/28190691/lack-of-lipid-screening-disparities-in-obese-latino-adults-at-health-centers
#15
John D Heintzman, Steffani R Bailey, John Muench, Marie Killerby, Stuart Cowburn, Miguel Marino
INTRODUCTION: In cross-sectional survey studies, obese Latinos are less likely to be screened for elevated serum cholesterol, despite their higher risk for hyperlipidemia and coronary artery disease. This study evaluated insurance and racial/ethnic disparities in lipid screening receipt between obese Latino and non-Hispanic white patients in Oregon community health centers (CHCs) over 5 years, using electronic health record data. METHODS: This retrospective cohort study evaluated obese (BMI ≥30), low-income, adult patients (aged 21-79 years) with at least one visit at an Oregon CHC during 2009-2013 (n=11,095)...
February 9, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28190669/insurance-status-affects-postoperative-morbidity-and-complication-rate-after-shoulder-arthroplasty
#16
Xinning Li, David R Veltre, Antonio Cusano, Paul Yi, David Sing, Joel J Gagnier, Josef K Eichinger, Andrew Jawa, Asheesh Bedi
BACKGROUND: Shoulder arthroplasty is an effective procedure for managing patients with shoulder pain secondary to end-stage arthritis. Insurance status has been shown to be a predictor of patient morbidity and mortality. The current study evaluated the effect of patient insurance status on perioperative outcomes after shoulder replacement surgery. METHODS: Data between 2004 and 2011 were obtained from the Nationwide Inpatient Sample. Analysis included patients undergoing shoulder arthroplasty (partial, total, and reverse) procedures determined by International Classification of Disease, 9th Revision procedure codes...
February 10, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28183825/insurance-status-and-racial-disparities-in-cancer-specific-mortality-in-the-united-states-a-population-based-analysis
#17
Hubert Y Pan, Gary V Walker, Stephen R Grant, Pamela K Allen, Jing Jiang, B Ashleigh Guadagnolo, Benjamin D Smith, Matthew Koshy, Chad G Rusthoven, Usama Mahmood
BACKGROUND: Cancer-specific mortality (CSM) is known to be higher among blacks and lower among Hispanics compared to whites. Private insurance confers CSM benefit, but few studies have examined the relationship between insurance status and racial disparities. We sought to determine differences in CSM between races within insurance subgroups. METHODS: A population-based cohort of 577,716 patients age 18-64 years diagnosed with one of the 10 solid malignancies causing the greatest mortality over 2007-2012 were obtained from SEER...
February 9, 2017: Cancer Epidemiology, Biomarkers & Prevention
https://www.readbyqxmd.com/read/28181683/oral-health-needs-dental-care-utilization-and-quality-of-life-perceptions-among-oregonian-seniors
#18
Richie Kohli, Harjit S Sehgal, Sandra Nelson, Eli Schwarz
BACKGROUND: For a relevant planning process and advocate for improvement in oral health conditions of the senior population up-to-date data are necessary. The objective of this study was to assess the oral health status, dental care utilization and quality of life perceptions of seniors in Clackamas County in Oregon. METHODS: Data were collected in a cross-sectional study on institutionalized and community dwelling older adults where participants completed a self-reported oral health survey, the short-form Oral Health Impact Profile (OHIP-14 questionnaire) and had clinical screenings...
February 9, 2017: Special Care in Dentistry
https://www.readbyqxmd.com/read/28176307/do-people-with-health-insurance-coverage-who-live-in-areas-with-high-uninsurance-rates-pay-more-for-emergency-department-visits
#19
James B Kirby, Joel W Cohen
OBJECTIVE: To investigate the relationship between the percent uninsured in a county and expenditures associated with the typical emergency department visit. DATA SOURCES: The Medical Expenditure Panel Survey linked to county-level data from the American Community Survey, the Healthcare Cost and Utilization Project, and the Area Health Resources Files. STUDY DESIGN: We use a nationally representative sample of emergency department visits that took place between 2009 and 2013 to estimate the association between the percent uninsured in counties and the amount paid for a typical visit...
February 7, 2017: Health Services Research
https://www.readbyqxmd.com/read/28176158/health-insurance-challenges-in-the-post-affordable-care-act-aca-era-a-qualitative-study-of-the-perspective-of-low-income-people-of-color-in-metropolitan-detroit
#20
Minal R Patel, Alison Jensen, Erminia Ramirez, Madiha Tariq, Ian Lang, Theresa Kowalski-Dobson, Joslyn Pettway, Michelle Famulare, Richard Lichtenstein
Low-income people of color are at risk of remaining uninsured due to a variety of factors. This study examined Affordable Care Act (ACA)-related and other health insurance enrollment experiences, observations, navigation needs, and experiences maintaining health insurance coverage among low-income communities of color in an economically disadvantaged community (Metropolitan Detroit). We conducted nine focus groups (n = 87) between May and June 2015. Participants were recruited through community-based organizations serving our key populations of interest...
February 7, 2017: Journal of Racial and Ethnic Health Disparities
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